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Whether incited by handicap, illness or drug use, the romantic movement was full of ghastly imaginings—such as those painted by Francisco de Goya—and fantastic scenes—as described in Samuel Taylor Coleridge’s "Kubla Khan." At least one great music mind of the time might also have been influenced by more than a general malaise, report the authors of a new paper published online January 24 in Medical Humanities.

Polish-born Frédéric Chopin, who died in Paris at the age of 39, is thought to have suffered from various ailments—both diagnosed and undiagnosed during his life—including pulmonary infections, frequent fever and possibly cystic fibrosis. Many experts speculate that his "melancholy" was a result of bipolar disorder or depression. A pair of Spanish researchers now reports that the 19th-century composer also might have endured a form of epilepsy.

Although he did not seem to suffer physically debilitating seizures, Chopin did report frequent but fleeting visual hallucinations, which might have been an indication of temporal lobe epilepsy, conclude the new study’s co-authors, Manuel Vázquez Caruncho and Francisco Brañas Fernández, both of the Complexo Hospitalario Xeral-Calde in Lugo, Spain.

During a trip to a Spanish monastery with his mistress George Sand in 1838, Chopin seemed frequently distracted, as Sand recalled in her memoirs: "The monastery was full of terrors and ghosts for him…I found him, at ten o’clock in the evening, pale in front of the piano, with wild eyes and his hair on end." A student recalled a similar occurrence: "With a cry Chopin left off playing, his hair stood on end—what I had hitherto regarded as impossible I now saw with my own eyes. But this lasted only for a moment."

In another instance, he suddenly left a private showcase concert in August 1848 during which he was playing his Sonata in B flat minor. The following month Chopin explained the episode in a letter to Sand’s daughter: "I was about play the March when, suddenly, I saw emerging from the half-open case of my piano those cursed creatures… I had to leave for a while to recover myself."

Certainly many illnesses are known to induce hallucinations. However, as the authors of the new study pointed out, those associated with schizophrenia, bipolar disorder and other psychological ailments are often auditory—rather than visual—in nature. And although migraine-induced aura imaginings can be visual, they are much more common in individuals older than 50 and last 15 to 30 minutes in addition to being followed by strong headaches. Chopin reportedly consumed small amounts of opium (in the form of laudanum) on the advice of his doctors, but as Caruncho and Fernández noted, Chopin’s hallucinations began before he began taking laudanum. And drug-induced hallucinations can incorporate many senses and when visual, "the images are usually abstract," the authors noted.

Epileptic hallucinations, on the other hand, can be complex, isolated and typically are only minutes or seconds in duration. And these brief events might not have been noticed or recognized as of importance by Chopin’s doctors, especially as "current understanding of epilepsy is a recent development" and contemporaries’ "testimonies interpreted these episodes as the expression of a sensitive and exquisite soul," Caruncho and Fernández wrote.

Of course, "we know nothing about his physical neurological state, nor have we imaging or electrophysiology tests that could help us establish a definite diagnosis," wrote the authors. But they concluded on a note of hope that "knowing he had this condition could help to separate romanticized legend from reality."

And although we might never be certain about Chopin’s brain, there is a possibility of learning more at least about his genetics and physical health from his heart, which remains preserved in Poland.